Transitional Pre-B to B Acute Lymphoblastic Leukemia
Approximately 20% of patients with acute lymphoblastic leukemia (ALL) present features of pre-B cells, i. e., small quantities of p, heavy chains in their cytoplasm and no detectable surface immunoglobulin [1, 2]. In individual patients, however, a subpopulation of cells bearing scant amounts of surface p. without detectable intracytoplasmic or surface light chains has been observed. This phenotype is thought to represent cells at a transitional pre-B/B cell stage of development, based on immunoglobulin expression [3, 4, 5]. Therefore, cellular phenotypes within pre-B ALL clones are variable in individual patients at diagnosis, may alter or shift in relapse (variable “window” of maturation arrest) as well as show some “asynchrony” of gene expression, but retain overall lineage fidelity . We report a very poor prognosis for a case of ALL in a 13-month-old female child with the phenotype of transitional pre-B/B lymphocytes, who relapsed early in treatment and retained the same major position and stringency of maturation arrest.
KeywordsToxicity Lymphoma Leukemia Adenosine Methotrexate
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